Obstetrics and Gynecology Hospital, Brasov, Romania.

Case report

We report a case of a 30-year-old G2P1 who was referred to our department at 31 weeks of gestation for a suspected anomaly of the fetal head. Her previous pregnancy was uneventful and she had non-contributive personal or family history. The ultrasound examination showed a midline vascularized cystic structure. The location and Doppler signal suggested an aneurysm of the vein of Galen.

High-output heart failure started to develop. The fetal heart was enlarged and jugular veins dilated. Fetus developed a hydrops with ascites and hydrothorax. The findings were so severe that it unfortunately died after delivery.

Images 1,2: Images show a midline cystic structure (indicated by arrows), Doppler shows a strong blood flow within the mass.

Images 3-8: Images show a vein of Galen aneurysm, note the vascularization of the mass, cause of the high-output heart failure.

Images 9, 10: Doppler curve demonstrating the flow within the aneurysm.

Images 11,12: Image 11 shows an enlarged fetal heart. Image 12 shows dilated jugular vein.

Images 13, 14: Images show carotid artery and jugular vein.

Images 15, 16: Dilated jugular veins, due to a heart failure.

Image 17: Doppler shows a pulsatile pattern of the umbilical vein and high impedance of the umbilical artery flow.